AB1733-PARE SHARED DECISION MAKING ABOUT RMD TREATMENT: WHICH VALUES MATTER TO PEOPLE WITH A MIGRATION BACKGROUND?
Authors: P. Pennings, None Msc, P. Borsje, Msc, B. Maat, A. Pasma, N. Kammah, R. Buijs, H. Geerders, L. J. Kranenburg - van Koppen, M. Beekman Msc, G. Willemsen- de Mey Msc
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> In the Netherlands, Shared Decision Making (SDM) between healthcare professionals and patients with a migration background stays behind, when compared to SDM with patients with a Dutch background. This can be due to the fact that patients with a migration background might hold different values when deciding on treatment. Values they find difficult to express. Values that health care professionals find difficult to talk about or understand.<sup>[1]</sup> Research into the values of inflammatory arthritis patients (IA) with a migration background will help health care professionals to better take these values into account, when deciding together on a best fitting treatment. <h3>Objectives</h3> In the Netherlands: • Which values are important to people with IA and a 1<sup>st</sup> or 2<sup>nd</sup> generation migration background when deciding on the best fitting IA treatment? • Do these values differ from those of the general Dutch population with IA? <h3>Methods</h3> To get an idea of the values that play a role in the choice of treatment, the National Association ReumaZorg Nederland (RZN) conducted research in 2020 amongst people with IA. It resulted in a list of most important values that was published². People with a migration background were underrepresented in the group of respondents. That is why RZN organized a focus group session in 2021 together with the Erasmus Medical Center (MC) in Rotterdam amongst 6 people with IA and a 1<sup>st</sup> or 2<sup>nd</sup> generation migration background. The focus group gave an insight into the values that play an important role, when choosing IA treatment. In order to verify these values within the broader migrant community of people with IA, RZN set out a questionnaire based on outcomes from the focus group and previous research² in June 2022. The questionnaire consisted of 56 values that could be scored on a 6-point Likert scale. Patient research partners of RZN provided feedback on the questionnaire. The approved questionnaire was then translated into Polish, Arabic, Turkish, English and Spanish. After translation, the questionnaire was made available through a unique online link. Adult patients, treated at the Erasmus MC with IA and a migration background, were invited to complete the questionnaire during their visit with their rheumatology nurse. Twenty-four patients completed the questionnaire. <h3>Results</h3> • Values that were scored as (very) important by most respondents focused on the effectiveness of IA treatment (on pain, fatigue, inflammation and on physical functioning). Respondents also placed great importance on clear information about IA treatment. Values with regards to the healthcare professional (someone: who helps to make a decision about treatment, who is involved, who has time and who listens) were also perceived as important. Finally, respondents placed great value on their wish not to depend on other people for their daily activities. • Values amongst people with IA and a migration background were ranked very similarly to the values amongst people with IA in the general study in 2020². Due to differences in the way values were scored in both studies, no statistical conclusion can be drawn from this. <h3>Conclusion</h3> Values with regard to the effectiveness of treatment and the supporting role of the healthcare professional are experienced as very important by patients with IA and a 1<sup>st</sup> and 2<sup>nd</sup> generation migration background. Healthcare providers should be aware of this and adapt their communication, if necessary. A safe environment is key for the willingness of people with IA and a migration background to participate in research. The question is if this safe environment is possible in a hospital setting. <h3>References</h3> [1]Hawley, S.T. and A.M. Morris, Cultural challenges to engaging patients in shared decision making. Patient Education and Counseling, 2017. 100(1): p. 18-24. [2]Cornelissen, L.E, et al. What matters to patients with rheumatoid arthritis when facing medical of non-medical treatment decisions?, Patient Prefer Adherence, 2021 Aug, 24; 15:1827 – 1841. <h3>Acknowledgements</h3> A special word of gratitude goes out to the rheumatology nurses of the Erasmus Medical Center. Thanks to their efforts, it was possible to reach this group of patients. Our gratitude also goes out to the patient research partners who contributed to the patient perspective in this project by either being part of the working group or by sharing their perspectives in the focus group. <h3>Disclosure of Interests</h3> None Declared.